Smell loss associated with SARS-CoV-2 is not clinically different from other viruses: a multicenter cohort study.

BACKGROUND: Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS: Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS: 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION: Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.

Influence of age and gender in the normal values of Sino Nasal Outcome Test-22.

OBJECTIVES: Sino Nasal Outcome Test (SNOT)-22 is a disease-specific outcomes measure questionnaire that combines rhinologic issues with general health issues. These issues may have variable weight on quality of life perception, and the influence of several factors such as gender, ethnicity, age, socio-cultural status and co-morbidities is unknown. The aim of this study was to evaluate the influence of gender and age on normal values of SNOT-22. DESIGN: Cross-sectional study based on application of SNOT-22 questionnaires to healthy volunteers. Participants were divided according to gender, and each gender was subdivided into age groups: 18-30 years, 31-40 years, 41-50 years, 51-60 years and over 60 years. SETTING: Rhinology Section, Sao Paulo Federal University. PARTICIPANTS: A total of 539 healthy volunteers (253 men and 286 women) were selected, so that each age group of each gender consisted of at least 50 individuals. MAIN OUTCOMES MEASURES: We applied SNOT-22 questionnaire to volunteers with no nasal or sinus disease. Median of score distribution was used as normal reference. RESULTS: Men presented lower scores than women (7 versus 9, P = 0.005). Subjects over 60 years presented significantly lower scores than other age groups (18-30 years = 10; 31-40 years = 8; 41-50 years = 9; 51-60 years = 9; over 60 years = 7). Men presented lower scores than women especially in 41-50 year and 51-60 year groups. CONCLUSION: Men and elderly presented the lowest Brazilian version SNOT-22 scores. The range of 0-8 points seemed to be more suitable as a normal value for this instrument, but this cut-off score could be tailored to age and gender specificities.